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(EID's) among academicians, scientists, and policy makers in the AsiaPacific
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China  Chinese
Army to Test New Recruits for HIV
China's People's
Liberation Army will begin testing new recruits for HIV this year. The
tests will begin in three districts of Beijing and expand to include
all new recruits. According to unofficial estimates the number of HIVinfected
people is near one million and according to state media reports, the
annual increase in HIV infections have increased by 30 percent over
the past several years. The government has issued a fiveyear plan to
keep the annual increase in infections below 10 percent.
[Associated Press 10/24/01]

AMERICAS

Canada
 Botulism Food Contamination
The Canadian Food
Inspection Agency (CFIA) and INDIANLife Food Corporation are cautioning
the public about consumption of INDIANLife brand Roti Wraps and six
varieties of Naan Breads. These products should not be consumed because
it is possible that they may support growth of bacteria causing botulism
in humans. The manufacturer, INDIANLife Food Corp., Burnaby, British
Columbia, is voluntarily recalling the affected products from the market.
The products have been distributed in British Columbia, Alberta, Saskatchewan,
and Manitoba. At this time there have been no reported illnesses associated
with the consumption of these products and the CFIA is monitoring the
effectiveness of the recall.
[PROMED 10/30/01]
Australia Vancomycinresistant Enterococcus
A Vancomycin Resistant Enterococcus outbreak at Royal Perth Hospital
in Western Australia involved 134 patients. Three were infected and
screening established that 131 were colonized. According to a clinical
microbiologist at the hospital, the outbreak has peaked and a small
number of colonized patients are being detected after active infection
control and antibiotic restriction program.
[PROMED 10/25/01]

RELATED NEWS

World Bank and WHO Global Tuberculosis Plan
The World Health Organization (WHO) and the World Bank have launched
a global plan to cut tuberculosis (TB) infection and death rates in
22 targeted countries that account for 80 percent of the eight million
TB infections contracted worldwide. The plan is estimated to cost
US$8.2 billion for implementation and US$10.2 over the next five years.
Of the 34 million TB cases expected in the target countries by 2005,
the plan is anticipated to detect and treat 21.5 million. The 22 countries
would be responsible for developing their own antiTB strategies with
the help of international agencies. In particular, the target countries
are urged to develop their own methods of instituting directly observed
therapy shortcourse programs. Currently, the worldwide funding from
governments and private donors provide only half the needed amount
for fighting TB infections. Officials plan to find donors for the
program among wealthy industrialized countries in Asia, Europe, and
North America.
[Reuters Health 10/24/01, 10/23/01]

2. UPDATES

US (Florida, New York, Washington, D.C.)  Anthrax Cases
Beginning Oct. 3, 2001, the US Centers for Disease Control and Prevention
(CDC) and state and local public health authorities have been investigating
cases of bioterrorismrelated anthrax. As of Nov. 2, 2001, the CDC
has confirmed 17 cases of anthrax in the United States, including:
two cases of inhalation anthrax in Florida; four cases of cutaneous
anthrax and one case of inhalation anthrax in New York City; three
cases of cutaneous anthrax and two cases of inhalation anthrax in
New Jersey; and five cases of inhalation anthrax in Washington, DC.
Suspected cases include three cutaneous cases in New York City and
one cutaneous case in New Jersey. Case confirmation is based on a
rigorous case definition that was published in the CDC's Morbidity
and Mortality Weekly Report (MMWR) on Oct. 19, 2001. On Oct. 31, 2001
an additional suspected case of cutaneous anthrax in New Jersey was
reported. Officials have said that anyone thought to have been at
risk for anthrax exposure is being offered antibiotics. Current treatments
of anthrax exposure include ciprofloxacin or doxycycline as initial
therapy.

The source of the majority of the anthrax cases have been attributed
to mail delivery to government or media organizations, however, there
have been two anthrax cases detected in women with no connection to
the postal service, government or media. These include a 51yearold
accountant in New Jersey and a 61yearold hospital worker in New
York.

Four persons have died from the bacteria. The 61yearold hospital
worker, Kathy T. Nguyen, who tested positive for inhalation anthrax
in New York died Oct. 31, 2001. The woman worked in a hospital supply
room, which may have shared space with or was in close proximity to
the hospital mailroom. New York Mayor Rudolph W. Giuliani has said
that environmental samples from the hospital have come back negative
and no one else in the workplace is showing signs of the disease.
In addition, two male postal workers in Washington, DC, aged 55 and
47, died on
Oct. 21 and Oct. 22, 2001, respectively. The fourth death, of a 63yearold
photo editor from Florida, was reported in the previous bulletin.

Traces of anthrax have been found in federal buildings, including
congressional office buildings, the Supreme Court, the State Department
and the health department as well as mailprocessing facilities for
the CIA, Department of Veterans Affairs Medical Center, and the White
House. In addition, several postal facilities were found to be contaminated
with anthrax. Investigations into the sources of anthrax contaminations
are still being carried out.

UNITED STATES (HAWAII)  DENGUE FEVER
As of Nov. 2, 2001 the total number of CDC laboratory confirmed cases
of dengue fever contracted in Hawaii is 74. On Maui there have been
56 cases, four cases on Kauai, 13 cases on Oahu and one case on the
Hawaii. Two suspected cases on Maui and three suspected cases on Oahu
have tested positive on preliminary screening tests. In addition,
there are 310 reports of illness under investigation.
[PROMED 11/03/2001]

2. NOTICES

NETWORK OF NETWORKS MEETING
A meeting organized
by the APEC Emerging Infections Network, "The Network of Networks
Meeting", will be held by invitation from Jan. 28, to Jan. 30, 2002
in Seattle, Washington, US. The meeting will include participation by
key individuals working in electronic networking from around the region,
representatives from the World Health Organization, and interested national
partners identified at the APEC Industry, Science and Technology Working
Group (ISTWG) meeting. Individuals will convene to discuss the development
of an integrated disease surveillance and alert network in the Asia Pacific
Region. Aims include enhancing geographic coverage of communication about
infectious disease, assuring accuracy and completeness of content about
emergent infectious disease, and assuring timeliness of information access
about epidemic disease activity in the region. For more information please
contact Alicia Silva at: apecein@u.washington.edu.

APEC EINet MEETING
A side meeting on infectious diseases convened in Penang, Malaysia on
Oct. 10, 2001 to review a recently completed APEC infectious disease strategy
and to begin planning for its implementation. A total of 19 delegates
from Australia, Canada, the United States, Hong Kong China, Chinese Taipei,
Korea, and Malaysia as well as two invited World Health Organization (WHO)
officials participated the meeting. The side meeting included an overview
of the history of cooperation on emerging infectious diseases, a presentation
from WHO, and a discussion about future actions. The meeting went well
and will feed into future planning and action related to the APEC infectious
disease strategy.

WHO STATEMENT ON SMALLPOX VACCINE
The World Health Organization (WHO) has stated that it is reconsidering
the use of the smallpox vaccine in instances where smallpox virus is deliberately
introduced to a population. However, the guidance on smallpox vaccination
states that vaccination of entire populations is not recommended. This
is due to the high incidence of adverse sideeffects with the vaccine,
including death, and the ability of the vaccine to prevent smallpox after
viral exposure. WHO recommends the use of the vaccine for people who are
at risk of exposure to smallpox, including health and civil workers. It
would also be used in a search and containment exercise if an outbreak
were to occur. In light of the recent anthrax cases in the US, WHO recommends
that governments verify their level of preparedness to handle diseases,
including smallpox. At present, there are no indications of possible intended
use of smallpox virus.
[WHO http://www.who.int/infpr/en/state2001㪨.html;
PROMED 10/22/01]

3. JOURNAL ARTICLES

SALMONELLA BACTERIA SEQUENCED
Two Salmonella bacteria, S. typhi
and S. typhimurium, have been sequenced recently. S. typhi
causes typhoid in humans, a disease that infects 16 million people each
year and kills 600,000, while S. typhimurium is a leading cause
of human gastroenteritis. The team investigating S. typhi (CT18)
sequenced its 4,809,037base pair (bp) genome using an antibiotic resistant
strain isolated from 9yearold Vietnamese girl suffering from typhoid.
Researchers investigating S. typhimurium strain LT2 sequenced the
4,857kilobase (kb) chromosome and 94kb virulence plasmid. Sequencing
of the genomes may lead to new ways to diagnose, treat and vaccinate against
both diseases. In addition, a comparison of sequences will most likely
identify reasons that the closely related bugs behave so differently..
[Nature 413, 848𤵄(2001); Nature 413, 852𤵈(2001)]

4.JOIN THE ELIST AND RECEIVE EINet NEWS
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